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Dr. Hasan
Dr. Hasan, Doctor
Category: Health
Satisfied Customers: 7296
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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I have a concern about 3 things - for the past 7 days - I have

Customer Question

I have a concern about 3 things - for the past 7 days - I have had intermittent dizziness, brought on by a ear problem after desending in a commercial jet. The pain in my left ear and just below my ear in my left neck area. I am on Bactrim DS 800 mg, one a day, via my Primary Care doctor. She says I have fluid in my ears. I saw her 5 days ago.

My two concerns are: Will the antibiotic help with remove the fluid? Is there anything else I can take OTC to help reduce the fluid? Why does it hurt below my ear? Thank you.
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Hasan replied 2 years ago.
HI,
Thanks for your question.
I am an ear, nose & throat specialist and wants to help you.
I will try to address all of your concerns separately and will be happy to answer your follow up questions.
Will the antibiotic help with remove the fluid?
Yes if the diagnosis of your doctor is fluid in the ear then yes antibiotic will help but there are other drugs which are required to drain the fluid. As you must be knowing that this fluid gets accumulated because of the the Eustachian tube dysfunction (its a tube behind the nose), the drugs like systemic decongestants and local decongestants help. Local decongestants include Xylometazoline nasal spray and systemic decongestant include tab sudafed. Xylometazoline nasal spray is required in the dosage of two puffs thrice daily for seven days and sudafed one tablet twice daily. Steam inhalation with menthol drops twice daily is also very helpful. nasal spray and sudafed can only be used if no high blood pressure issues are there. Pain killers are required to address the pain.

Is there anything else I can take OTC to help reduce the fluid?
yes all of above are OTC but one should always inform doctor before using them.

Why does it hurt below my ear?
It hurts below the ear because the infection might have spread to lymph gland below the ear.

I wish you good luck that you get well soon.

If you have any question, please let me know.

Regards

Dr Hasan
Customer: replied 2 years ago.
Dr. Hasan, thank you for the great advice - I appreciate it. What can I do the keep the Eustachian tube clear when I am flying? The pain in my neck under my ear when the jet descends is terrible. I tried chewing gum, yawning, etc. nothing worked.

Also, will the Eustachian tubes ever become normal again? This flight was Florida to New York City and I had this trouble. I have flown to Paris from Florida and not have any problems at all.

I think for me the dizziness is the worse part.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your input.

Usually i advise my patients with similar problems to use Xylometazoline spray while taking off and while landing. Moreover i ask them to take a sudafed before the flight. Using chewing gum is required while landing because its in landing basically when the tube fails to equalize the pressure.

Yes it can become normal but you should visit ENT and should get tympanometry test to confirm this dysfunction. Moreover nasal steroid sprays and sudafed is required initially and suppose it doesn't respond to the medical management, then procedure called myringotomy and grommet insertion is required.

Dizziness in the form of spinning is related to ears and if you have this then inner ear infection can be suspected. Bactrim should help this. OTC Tab meclizine thrice daily really helps with dizziness in my patients. But i strongly advise you to see ENT for further evaluation because this problem should be addressed by ENT rather than PCP.

If still any question, please let me know.

Please spare sometime to leave positive feedback.

I wish that you get well soon.

Regards
Dr. Hasan, Doctor
Category: Health
Satisfied Customers: 7296
Experience: MBBS, FCPS, with experience in all fields of medicine and surgery
Dr. Hasan and 5 other Health Specialists are ready to help you
Customer: replied 2 years ago.
Thank you.
Expert:  Dr. Hasan replied 2 years ago.
You are most welcome.
you can always come back on this page to ask more about your problem.
Regards
Customer: replied 2 years ago.
I did accept your answer and gave a $7 tip. Thank you, sir.
Expert:  Dr. Hasan replied 2 years ago.
Yes i know this but i sent you this message so that you can always feel free to contact me again for your problem.
Take care of yourself.
Customer: replied 2 years ago.
Dear Hasan, I would like to ask a few more questions if you are available. I went to my ENT doctor today and I would to run a few things by you please. Thank you.
Expert:  Dr. Hasan replied 2 years ago.
HI, Yes sure, i am here for you.
Customer: replied 2 years ago.
Thank you Sir. Very much. I just got back from my ENT - they checked my ears, all is good, but when he put the flexible scope into my nose, he discovered at the adnoid was enlarged and he was concerned. because of my age (soon 59) and he wants to do adnoidectomy to remove it. Also to send it off to the lab to check for any cancer cells. I do not smoke or drink and anything bad. I was not expecting this turn of events. I asked if there were other options and he told me that this was the only option. I asked if antibiotics would help shrink it and he said would could certainly go that route but it would have no effect.

My question is: what is your opinion? I have never had surgeries of any kind and quite frankly I am scared.
When I asked and I saw the enlarged adnoid, he said it didn't look like cancer but he still wanted a biopsy.

Your thoughts, please..
Customer: replied 2 years ago.
Also, I forgot to mention, the reason I had ear problems was because this adnoid (about one inch) was pushing on the tube that goes into my ear.
Customer: replied 2 years ago.
He did prescribe Amoxicillin for a course of ten days just to see if the adnoid would shrink, because I insisted.

These events all happened today.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your input.

First of all i would like to mention that if he is suspecting adenoids then that's good because by saying so he is not suspecting cancer at the top of list. I really agree that its not usual to have adenoids at this age. The point is what to do now. If you were my patient yes i would have gone for its removal with a biopsy. You should not be scared, i agree one gets concerned but there is no other way than to get a biopsy.There are few things which are in your favor. You don't have lymph nodes in neck and if that was cancer, lymph nodes are there most of the time because nasopharynx is one of the site where lymph node metastasis is so high that even patients present with lymph nodes first and mass is discovered later so not having all this is a point in your favor. Cancers i nasopharynx are most commonly in the lateral walls (left or right), your doctor is suspecting adenoids so he must have seen a mass in mid line (where adenoids is usually seen) so that makes cancer less likely but biopsy is mandatory but without being stressed. I hope this helps you. If any question, please let me know, please leave positive feedback if you think that i have helped you. I am here till you want so don't worry. Regards
Customer: replied 2 years ago.
Do you think the amoxcillin will help shrink the adnoid? I asked him if I decided to wait, he told me he could no longer be my doctor because he wants to make sure with the biopsy. There are also complications from surgery that I am apprehensive of. Please help me.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your input. Yes amoxicillin can help. This can be adenoid enlargement due to nasopharyngitis (infection of the nasopharynx) like tonsillitis. So yes in that case it can help and there is no risk in taking a chance with a course of antibiotics. Its not a complicated procedure. However you can ask him to take a biopsy under local anesthesia and if it comes out to be just adenoids (which i pray that it should) you can get it removed a later stage. I hope this helps you. If any question, please let me know, please leave positive feedback if you think that i have helped you. I am here till you want so don't worry. Regards
Customer: replied 2 years ago.
I did ask my ENT if we could do a biopsy without the surgery and he told me it is a difficult thing to do. Something it being very uncomfortable for me, blood issues and something about a balloon? I don't know.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your reply. If he is not comfortable then go for it under general anesthesia. If you don't have any diagnosed problem like bleeding diathesis then bleeding is not a major issue. Balloon, yes it makes uncomfortable but after adenoids removal we don't use balloon or packing. you can ask him to take a biopsy and to remove the rest of tissue with LASER. If he can do this, the risk of bleeding significantly reduces. I hope this helps you. If any question, please let me know, please leave positive feedback if you think that i have helped you. I am here till you want so don't worry. Regards
Customer: replied 2 years ago.
So, if I may ask 3 more questions (YOU HAVE BEEN WONDERFUL AND SO HELPFUL). So you are saying I can in a nutshell - I can a biopsy without doing the adnoidetomy, to get a sample? And the use of a laser to remove the remainder of the tissue? Is this something he can do in his office? Thank you.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your reply. Its my pleasure really to help you. Yes but biopsy will be done in operation theater under general anesthesia. He will take the biopsy and can remove rest of the adenoid with LASER. The biopsy is taken first because LASER burn the tissues so biopsy become inconclusive. So biopsy is taken first to get a conclusive report. This is a suggestion and definitely your doctor needs to agree on this, this depends on his comfort, thoughts and expertise. This is just to minimize the chances of bleeding. I hope this helps you. If any question, please let me know, please leave positive feedback if you think that i have helped you. I am here till you want so don't worry. Regards
Dr. Hasan, Doctor
Category: Health
Satisfied Customers: 7296
Experience: MBBS, FCPS, with experience in all fields of medicine and surgery
Dr. Hasan and 5 other Health Specialists are ready to help you
Customer: replied 2 years ago.
Yes! Dr. you have helped me!!! I will keep you posted as I learn more after the course of antibiotics are completed. Thank you, SIr.
Expert:  Dr. Hasan replied 2 years ago.
It would be a pleasure to assist you. I wish you best of luck.
Expert:  Dr. Hasan replied 2 years ago.
HI,

Just wanted to know that how are you feeling now?

Regards
Customer: replied 2 years ago.
Dr. Hasan, I have been on the Amoxcillin now, my second day of a 10 day course. I feel better. I have a follow-up appt in 13 days. I am in the hopes that the adenoid has shrunk some. Do you think that is possible? (I Think I already asked you this question, I apologize). I know for me, I will be very conservative in my treatment. I believe I will end up not having the surgery.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your input. I am happy that you believe that you will not end up with surgery and you know, belief is half cure. Yes its possible that amoxcillin is helping the infection in the adenoid. Adenoid is basically a lymphoid tissue and it can get enlarged due to infection. If infection is being cured, the tissue can regress. However i cannot give you false hope, but hope is there. Regards
Customer: replied 2 years ago.
Also, it helps that you mentioned that the enlarged adenoid was the primary focus of my local ENT physician and not suspecting cancer at the top of his list. He has been in practice 8 years and he said this was the first time he even saw an adult with adenoids. If it continues, I will seek a second opinion. I will not let this situation get pushed aside. But I am in the hopes that the amoxicillin does reduce it.
Expert:  Dr. Hasan replied 2 years ago.
I really wish that things go fine for you. Really i have not seen adenoids at your age in my 6 years of ENT practice. Let the amoxicillin course finish and then decide accordingly. I am really hopeful in your case. My prayers are with you also. :)
Have a good day.
Customer: replied 2 years ago.
Thank you SO much Dr. Hasan. I appreciate all your advice, it has helped me so much.
Expert:  Dr. Hasan replied 2 years ago.
You are most welcome.
Expert:  Dr. Hasan replied 2 years ago.
Hello, good day, I have just seen that you asked me a question but the question is closed. Probably I was offline, that's why? How can I help you ?
Regards.
Customer: replied 2 years ago.
It was just one thing. I don't want to interrupt your medical practice and schedule. But I was wondering, if my ENT and you also mentioned that you had never seen an enlarged Adenoid in adult, even though another physician has, from the appearance of the adenoid, clear and round, if cancer was in the adenoid, would not show as difficult color, blood, shape?
Expert:  Dr. Hasan replied 2 years ago.
Thanks for your question. It's ok you can ask me anything you want and at anytime. I can get back to you when possible at the earliest. Yes your concern is right. Adenoid does has a characteristic look and is different from cancerous mass in shape, however color of overlying mucosa is same in both. That is the reason that I agreed with your ENT because an ENT is not likely to miss adenoid. If anything not clear, please feel free to ask more and please donot ever hesitate to ask anything in future. Regards
Customer: replied 2 years ago.
Because I am not a doctor and am hoping for a good shrinkage after the antibiotic regime. DId you say the color of the overlying mucosa is the same without cancer and with cancer? It is a clear round adenoid, no color inside or out. I also do not have any other characteristics of cancer. I.e., swollen glands, pain, etc. I do not smoke and no longer have any dizziness.
Do you see where I am going with this? Especially, when I am not having the surgery. But I don't want to make an error either?
Expert:  Dr. Hasan replied 2 years ago.
Yes, the color of mucosa is same in both cases however the look is different because in cancer mucosa can be irregular or sometime smooth, in adenoids mucosa has ridges in it. Having no associated symptom is good thing but you have to get a biopsy atleast which is mandatory. I think you have to wait, hoping for the best till you get a biopsy. The chances of having nothing serious are high according to my experience but biopsy is mandatory. On follow up if the mass completely goes away, only then nothing further need to be done but this is quite unlikely with adenoid however significant reduction can still be expected. I wish you good luck for all, please donot stress yourself. i hope this helps you. please ask for any query. please click accept if i have answered your question. regards. Dr Hasan
Dr. Hasan, Doctor
Category: Health
Satisfied Customers: 7296
Experience: MBBS, FCPS, with experience in all fields of medicine and surgery
Dr. Hasan and 5 other Health Specialists are ready to help you
Customer: replied 2 years ago.
And my problem sir, is that the only way my physician can do the biopsy is via surgery and I am not planning on doing that. I will hope and pray that it does reduce in size with antibiotics. I appreciate all your help.
Expert:  Dr. Hasan replied 2 years ago.
Thanks for the accept and feedback but I am getting worried because you are looking stressed today, may I know why? Have you read anything etc? Please write back to me, I would be happy to assist you specifically as per your concerns. You are getting better according to your symptoms do why you are stressed? Please donot be, let me know what happened ?
Regards
Customer: replied 2 years ago.
I just want you to know that I did submit another payment for your help today. I agree with you, I am stressed because I know in the past, I have always been able to get through illnesses, broken bones, etc. with no problems or surgeries. I have put all my hopes in the antibiotic treatment. I was not expecting an answer that the Mucosa is clear in both non-malignacy and also malignacy. I guess I am afraid if on the follow-up visit on the 14th with my ENT, there will be a conflict between my doctor and I if I still refuse the biopsy with the removal of the adenoid.
Customer: replied 2 years ago.
I appreciate your help - I guess it is hard for me because I am not a medical professional just a regular person being given unexpected health results from my ENT. I will keep you posted. But in the end, I will hope for the medicine to work, a shrinkage of the adenoid and no surgery. There can be additional problems with surgeries, as I have noticed with people in my family. Thank you Dr. Hasan for all your help. You are the best!
Expert:  Dr. Hasan replied 2 years ago.
Yes i can understand your anxiety. Even i would be anxious. The mucosa over adenoid and tumor can look normal or same but as i said adenoid is a lymphoid tissue and has a characteristic look. So really you can hope for the best. Donot stress yourself till you see your doctor and i advise you to accept his advise. There are usually no additional problems with surgery usually. Ok here is an other suggestion, this is not a standard procedure but i am just mentioning for your help. You can ask your doctor, if he agrees well and good, if he donot he will be justified. You can ask him that whether he can get a PET scan for you. I like CT scan but with a dye which is picked up by cancer cells and can show that a mass is cancer or not. We donot use it for diagnosis, we use it for follow up of cancer patients but just ask him, if he agree. But again its not something which he should agree, i am just mentioning for your help. If he donot then please get it removed. :) have a good day.
Customer: replied 1 year ago.

Dr. Hasan,


 


I just wanted to let you know that my adenoid situation cleared itself up with antibiotics - no swelling or anything.


 


I did not opt for the surgery and I am glad - thank you for all your time.


 


I really appreciate it.

Expert:  Dr. Hasan replied 1 year ago.
Thanks a lot for your input. I am really feeling very happy for you. I am glad that my suggestion and reassurance was right. Good luck for everything else in your life and please feel free to contact me anytime for anything. Take care of yourself and enjoy this beautiful life. Best regards , Dr Hasan.
Customer: replied 1 year ago.

Thank you SO much, Dr. Hasan - wishing you continued success in all you do - you do make a difference in people's lives. Regards, R

Expert:  Dr. Hasan replied 1 year ago.
Thanks a lot :)
Customer: replied 1 year ago.

Hello Dr. Hasan,


 


I don't have a question for you but wanted to give you an update - everything is perfectly fine with my nose issue. It turned out to be a infection which inflamed the area. You were great to help me back in April and May, 2012.


 


Much continued success to you Dr. Romaine 445

Expert:  Dr. Hasan replied 1 year ago.
You are most welcome. I wish you a happy and healthy life. Regards

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